Study shows COPD is associated with significant and persistent pain

May 21, 2013

Chronic obstructive pulmonary disease (COPD) is primarily associated with the respiratory symptoms that are its hallmark, but in fact, patients who struggle with the disease also experience significant amounts of chronic pain. A new study conducted by researchers in Pennsylvania and New Mexico estimates the degree of pain suffered by these patients to be close to that experienced by patients with osteoarthritis and rheumatoid arthritis.

The research results will be presented at the ATS 2013 International Conference.

"Several studies have found high rates of pain medication use among COPD patients, and pain has also been an important determinant of overall health status and quality of life in COPD," said study lead author Melissa Roberts, MS, senior research associate at the Lovelace Clinic Foundation in Albuquerque and a doctoral candidate at the University of New Mexico College of Pharmacy.

"In prior studies, we had observed increased narcotic and non-narcotic pain medication use among individuals with COPD and were interested in whether this was because the COPD population tends to be older and have more comorbidities, or whether there might be an association between COPD and pain above and beyond what age and comorbidities might explain," she said. "In this study, we chose to compare chronic pain in individuals with COPD and individuals with chronic conditions that similarly affect multiple body systems."

The retrospective study used data gathered from 7,952 COPD patients and 15,904 non-COPD patients over the age of 40 who were enrolled in a managed care system in the southwestern United States from 2006 through 2010. The presence of pain was determined by pain-associated diagnosis codes, the use of pain therapy and outpatient prescription claims for pain medication, and recurrent therapy and prescriptions were considered evidence of chronic pain.

The researchers found that compared to those with non-COPD chronic disease, a greater number of patients with COPD had some indication of chronic pain and use of pain-related medications, including both short-acting and long-acting opioids. However, chronic pain was not associated with lung function impairment among the study patients, suggesting the causes of pain are not directly associated with airflow obstruction. The only subset of patients with greater prevalence of chronic pain and use of pain medication were patients with either rheumatoid arthritis or osteoarthritis.

"We found the prevalence of chronic pain among adults with chronic disease to be almost twice as high as among individuals without chronic disease," Ms. Roberts noted. "Among those with chronic disease, individuals with COPD were similar to those with rheumatoid arthritis or osteoarthritis in their experience of pain, but with even greater use of opioids."

An investigation of the incremental costs associated with chronic pain is under way, she noted.

"The socioeconomic impact of chronic pain on patients with COPD is also an understudied issue, and many health care organizations conduct management programs for chronic diseases which significantly impact quality of life," Ms. Roberts said. "Among individuals with COPD, pain may be having a marked impact on their quality of life, potentially as much as their respiratory disease, and contributing significantly to their cost of care."

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